Provider Demographics
NPI:1952550956
Name:COMTOIS, MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:COMTOIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2554 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2711
Mailing Address - Country:US
Mailing Address - Phone:816-527-0832
Mailing Address - Fax:
Practice Address - Street 1:620 E 18TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1510
Practice Address - Country:US
Practice Address - Phone:816-554-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080226481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical